title: D-dimer is a marker of response to chemotherapy in patients with metastatic colorectal cancer.
abstract: OBJECTIVE
  D-dimer, LDH and tumor markers are usually overexpressed in colorectal carcinomas (CRC). Our purpose was to assess the prognostic role of D-dimer, lactate dehydrogenase (LDH), CEA, CA19-9 and CA72-4 in patients with metastatic CRC treated with XELOX chemotherapy.
  
  
  METHODS
  Thirty-eight CRC patients who had evidence of distant metastasis were enrolled in the study and blood samples were taken before chemotherapy for estimation of the tumor markers CEA, CA19-9 and CA72-4, and for D-dimer and LDH. Patients were randomized into 3 groups: those with partial response (PR), stable disease (SD), and progressive disease (PD) according to their clinical and radiologic evaluation after 3 cycles of XELOX chemotherapy. All parameters were reevaluated after the 3rd cycle of chemotherapy.
  
  
  RESULTS
  Eighteen patients (47.3%) achieved PR, 10 (26.3%) SD, and 10 (26.3%) showed PD. After 3 cycles of XELOX CEA (20.55 vs 11.97 ng7sol;ml; p=0.002), LDH (357.50 vs 214.0 U7sol; lt; p=0.001) and D-dimer (1.56 vs 1.17 μgFEU/ml; p=0.022) levels were significantly decreased in the PR group. D-dimer levels were also notably decreased (1.36 vs 0.77 μgFEU/ml; p=0.021) in the SD group. In the PD group a considerable increase was seen in CA 19-9 (119.5 vs 243.09 U/ml; p=0.025), CA 72-4 (5.18 vs 25.8 U/ml; p=0.036) and D-dimer levels (1.77 vs 1.88 μgFEU/ml; p=0.012).
  
  
  CONCLUSIONS
  This study demonstrated that D-dimer, LDH and tumor markers can be helpful in determining CRC prognosis in patients with metastatic disease. D-dimer, LDH and tumor markers provided unique prognostic information in advanced CRC patients.
authors.affiliation: Erciyes University, Department of Oncology, Kayseri, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Inanc
authors.forename: O
authors.initials: O
authors.lastname: Er
authors.forename: H
authors.initials: H
authors.lastname: Karaca
authors.forename: V
authors.initials: V
authors.lastname: Berk
authors.forename: M
authors.initials: M
authors.lastname: Ozkan
authors.forename: M
authors.initials: M
authors.lastname: Dikilitas
authors.forename: F
authors.initials: F
authors.lastname: Elmali
mesh_terms: D000368:Aged; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018395:CA-19-9 Antigen / Q000097:blood; D000069287:Capecitabine; D002272:Carcinoembryonic Antigen / Q000097:blood; D002277:Carcinoma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010071:Oxaloacetates; D016016:Proportional Hazards Models; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D018395:CA-19-9 Antigen; C083825:CA-72-4 antigen; D002272:Carcinoembryonic Antigen; D005338:Fibrin Fibrinogen Degradation Products; D009944:Organoplatinum Compounds; D010071:Oxaloacetates; C036309:fibrin fragment D; D003841:Deoxycytidine; D000069287:Capecitabine; D007770:L-Lactate Dehydrogenase; D005472:Fluorouracil